Building Public/Private Partnership for Health System Strengthening Contracting: Overview Peter Berman The World Bank Bali Hyatt Hotel, Sanur , Bali 21-25 June 2010. Outline. Separating the financing and delivery functions in government programs
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for Health System Strengthening
The World Bank
Bali Hyatt Hotel, Sanur, Bali
21-25 June 2010
The key innovation in contracting is for government to separate the financing and delivery functions
I pay myself for the services I produce
I control the budget
I produce services
Purchaser and provider
The traditional setting
I contract & pay someone to produce services
I control the budget
I produce services under a contract in exchange for a payment
I must show results
The new setting
Rationale for contracting: Introduce market mechanisms
Replace direct, hierarchical management structures by contractual relationships between purchasers and providers, where incentives play a key role in promoting better performance.
Low public sector efficiency
Example: Government officials may be empowered to seek their own economic benefits (rents) from postings and transfers, licensing, and other government functions
What is a “contract”? Contracting is the use of contracts to achieve objectives
Monitoring and Evaluation (M&E)
Contracting can be done with public or private providers
Advantages and disadvantages of contracting contracts to achieve objectives
One Example contracts to achieve objectives
NGO Contracting in Cambodia
Detailed Impact Evaluation
4) What do you think would be the obstacles to sustainability of contracting in your context in which you work?
5)What would be the advantages and disadvantages of increasing the scale of each contract to cover 2 or 3 operational districts?
Concluding Thoughts contracts to achieve objectives